INTRODUCTION: Antimicrobial resistance (AMR) poses a critical global health threat, with millions of deaths attributed to it annually. Antibiotic stewardship to combat AMR is the responsibility of all healthcare professionals. Despite evidence suggesting that it is unnecessary, dentists routinely prescribe prophylactic antibiotics following third molar (3M) surgeries. METHOD: This mixed-methods study examined the behavioural barriers influencing antibiotic prescribing practices within the Division of Oral and Maxillofacial Surgery at the National University Centre for Oral Health Singapore. This study used the capability, opportunity and motivation for behavioural change or COM-B framework to implement interventions targeting the behavioural barriers. RESULTS: Pre- and post-intervention data over 6 months showed a significant reduction in antibiotic prescriptions from 84.45% to 20.89%, following the implementation of COM-B strategies (P<0.001). Qualitative feedback from focus group discussions highlighted a positive shift in clinicians' attitudes towards antibiotic reduction, acknowledging the minimal infection risk associated with non-prescribing practices. Notably, complication rates remained stable throughout the study period, indicating no adverse effects from reduced antibiotic usage. CONCLUSION These findings demonstrated that the COM-B model can be successfully applied to modify deeply ingrained prescription habits, and underscored the effectiveness of a structured behavioural change intervention in enhancing compliance with antibiotic stewardship guidelines. The study advocates continuation of initiatives to sustain this positive trend and mitigate AMR in clinical practice.
Humans ; Molar, Third/surgery* ; Anti-Bacterial Agents/therapeutic use* ; Singapore ; Antimicrobial Stewardship/methods* ; Practice Patterns, Dentists'/statistics & numerical data* ; Antibiotic Prophylaxis ; Female ; Attitude of Health Personnel ; Male ; Tooth Extraction ; Adult ; Focus Groups ; Practice Patterns, Physicians'

PURPOSE: The purpose of this study was to define and clarify the concept of political competence for nurses.METHODS: A hybrid model method was used to investigate the dimensions, attributes, and definitions of the concept. In the theoretical stage of the study, literature on nursing, politics, and other discipline were reviewed. In the fieldwork stage, individual in-depth interviews and focus groups interviews were conducted with politically seasoned experts or activists who had an understanding of the concept of political competence for extensive descriptions in nursing and field of health care.RESULTS: The concept of political competence was represented in four dimensions as political knowledge, political efficacy, political interaction, and political activity. In the political knowledge dimension, there were three attributes, namely, political knowledge, political information and systematic analysis ability. The political efficacy dimension had three attributes of internal political efficacy, external political efficacy, and self-pride of nursing profession. The political interaction dimension had three attributes of organizations and community service, networking, and persuasive power. The political activity dimension had six attributes of political leadership, political expression, assertive behavior, political advocacy, political participation, and policy intervention.CONCLUSION: This concept development might provide a basic understanding of developing a measurement tool and for constructing a theory promoting nurses' political competence.
Concept Formation ; Delivery of Health Care ; Focus Groups ; Leadership ; Mental Competency ; Methods ; Nursing ; Politics ; Professional Competence ; Seasons ; Social Welfare

methods research was applied. For qualitative research, a semi-structured focus group interview was conducted with six health professionals. For quantitative research, a self-reported survey was administered. A total of 542 health professionals participated in the survey, and 526 completed the entire questionnaire. Health professionals showed positive attitudes toward precision medicine. About 95–96% of respondents agreed that precision medicine will be effective in treatment and precise diagnosis, and 69.9% reported that they would participate as study subjects. Meanwhile, they expressed concerns regarding educating patients and health professionals in precision medicine and developing research and data sharing infrastructure. Also, they emphasized the importance of developing precision medicine in an equitable way. Despite varying levels of awareness of precision medicine, the health professionals expressed a willingness to engage in precision medicine research, and recommended that health professionals work closely with policymakers to design precision medicine in a way that can be effectively adopted. Health professionals showed had a positive, but cautious, attitude toward precision medicine. The results of this study suggest areas to be addressed before ushering in precision medicine in Korea.]]>
Diagnosis ; Focus Groups ; Health Occupations ; Humans ; Information Dissemination ; Korea ; Methods ; Precision Medicine ; Qualitative Research ; Surveys and Questionnaires

OBJECTIVES: A Womans University College of Medicine faces curriculum reform in 2020. To determine what reforms are needed in the premedical curriculum, a needs assessment was conducted.METHODS: This study utilizes qualitative study method. A focus group interview was conducted with four students who completed premedical courses from November to December 2018. Interviews were conducted in two groups by grade level, and each interview was recorded. After transcribing the recorded contents, four researchers analyzed the data using conventional content analysis.RESULTS: Students chose A Womans University College of Medicine considering their future careers as female medical professionals and other considerations such as scholarships. The students expected diverse experiences, exchanges with students in different departments, and fusion of medicine with other fields during their premedical years. Overall, these expectations were met during the course, but individual needs for customized education, such as liberal arts, were unmet. In general, students' attitudes toward premedical courses were very motivated and they actively used resources provided by the university.CONCLUSION: Qualitative research can provide a better understanding of quantitative data, such as a student survey performed to prepare for curriculum reform. Based on this understanding, the curriculum will be reformed to reflect the educational needs of students, to motivate students and to provide satisfactory education.
Curriculum ; Education ; Education, Medical ; Fellowships and Scholarships ; Female ; Focus Groups ; Humans ; Methods ; Needs Assessment ; Program Evaluation ; Qualitative Research ; Students, Premedical

PURPOSE: This study aimed to seek agreement on the core components of an e-learning cultural competence program for Korean public health workers (PHWs) while prioritizing educational content areas. METHODS: A two-round Delphi study was performed with 16 Korean experts from five disciplines. Data were collected between August 30 and November 24, 2017. A questionnaire was developed from literature reviews and previous focus group interviews concerning PHWs. The panel members were asked to rate the importance and urgency of educational content areas and the effectiveness of teaching–learning methods and gave opinions on their appropriate frequency, duration, and target audience. Responses were analyzed using descriptive statistics. A median of 4.0 or greater or a rate of agreement of 75% or greater was considered a “consensus” for the purposes of this study. RESULTS: All consenting participants responded to two-round surveys. Participants reached consensus on thirty-one educational content areas. Of these, the highest priorities were “necessity of cultural competence of PHWs,” “health characteristics according to race and ethnicity,” and “establishing trusting relationships with migrants.” The most effective teaching–learning method was case-based learning, with seven to eight sessions of training and duration of fewer than 30 minutes per session. CONCLUSION: Multidisciplinary experts proposed 12 prioritized educational content areas and effective teaching–learning methods as well as their frequency, duration, and target audiences, reflecting Korea-specific multicultural phenomena and the nature of the work of PHWs. These findings can contribute to preparing PHWs to provide culturally competent services to migrants in their communities.
Consensus ; Continental Population Groups ; Cultural Competency ; Delphi Technique ; Education ; Focus Groups ; Health Personnel ; Humans ; Korea ; Learning ; Methods ; Public Health ; Transients and Migrants

PURPOSE: This study aimed to develop a web-based cost management program for visiting nursing centers (CMP-VNC), using time-driven activity-based costing (TD-ABC), and to analyze effects of the program. METHODS: The CMP-VNC was developed using the combined prototyping approach and system developing life cycle method following four stages: need analysis with comprehensive literature reviews and focus group interviews, design and development of program algorithm, evaluation of the developed program validity using experts and users group, and application and effects analysis. The non-equivalent control group pretest-posttest design was used to analyze the effects of the program. The program demonstration was conducted for four weeks with 60 visiting nurses in 35 visiting centers. RESULTS: The web-based program was developed. It has five interfaces with basic and special functions using TD-ABC, namely, input, visiting nursing activity, visiting nursing activity cost, cost efficiency, and cost calculation report. The experimental group showed significantly higher cost perception and cost confidence than control group. CONCLUSION: We found that the CMP-VNC can be an effective tool to increase visiting nurses' competency of costing and enhance efficiencies of visiting nursing centers.
Costs and Cost Analysis ; Focus Groups ; Internet ; Life Cycle Stages ; Methods ; Nurses, Community Health ; Nursing

PURPOSE: Continuing professional development is essential for improving health care services, especially in developing countries. Most of the training programs in Mongolia were not based on a targeted needs assessment. Therefore, we aimed to apply a mixed methods design to assess the training needs of Mongolian health professions. METHODS: We conducted a needs assessment using a convergent parallel mixed methods design in two steps. The survey and interview questions were developed to identify priority areas, targeted trainees, and effective training methods. A survey on 60 respondents, 15 individual interviews, and a focus group interview with 14 participants were conducted in the first step. In the second step, 12 representatives of key stakeholders were invited to a second focus group interview. RESULTS: Current health policy areas, areas related to future national plans, and areas not currently receiving governmental or international support were suggested as the main priorities. The stakeholder suggested that trainees should be selected based on their professional experience and language level, as well as each hospital’s needs. Building teams including various professions, such as nurses, technicians, and biomedical engineers, was recommended as a way to exchange ideas with each other and to build teamwork for future collaboration. CONCLUSION: Medical training needs are dynamic and complex; therefore, a deep understanding of the context and setting is necessary. In this study, we assessed the targeted training needs of Mongolian health professions through a mixed methods design, which could be an effective way to conduct needs assessments for training programs.
Cooperative Behavior ; Delivery of Health Care ; Developing Countries ; Education ; Fellowships and Scholarships ; Focus Groups ; Health Occupations ; Health Policy ; Methods ; Mongolia ; Needs Assessment ; Surveys and Questionnaires

PURPOSE: The objective of this phenomenological study was to explore nursing students' emotional experiences in the school life. METHODS: Twenty-four nursing students participated in the study. Data were collected from May 2017 to February 2018 using focus group interviews and later analyzed using the Colaizzi's method. RESULTS: In our study, 311 meanings were obtained from the participants, including 19 sub-themes and seven theme clusters. The seven theme clusters were; ‘looking back on the past,’ ‘face to reality,’ ‘recognizing me,’ ‘anxiety about uncertainty,’ ‘nursing student's way,’ ‘looking around,’ and ‘patting for my mind.’ The emotional experiences of nursing students in college life were classified into four categories: ‘self-reflection for growth,’ ‘discovery for growth,’ ‘hoping for growth,’ and ‘search for the growth.’ CONCLUSION: Although nursing students may be equally exposed to anxious and stressful situations, their activities, adaptability and levels of achievement vary depending on emotional experiences of each person. Considering the continuous curriculum of nursing, it is necessary to develop emotional management strategies and relevant training programs considering different types and levels of emotional issues for the nursing students.
Curriculum ; Education ; Focus Groups ; Humans ; Methods ; Nursing ; Qualitative Research ; Students, Nursing

PURPOSE: The purpose of this study was to explore the experiences of perception of nursing students' rights participating in clinical practice.METHODS: This descriptive study carried out purposeful sampling. The participants were 17 nursing students, who had experience of participating in clinical practice for more than 12 weeks. Data were collected through focus group interviews. Twelve subjects were in their third year and five in their fourth year. All were practicing in secondary general and tertiary university hospitals. The data were analyzed using classical content analysis method.RESULTS: The researchers extracted 23 codes representing the nursing students' rights of clinical practice, which were grouped into 4 categories and 11 subcategories. The 4 categories were ‘deep disappointment as an alienated person in a clinical field’, ‘clinical practice experience that cannot be given up despite difficulties’, ‘need for a practice environment that takes care of nursing students’, and ‘hope for support, advocacy and respect’.CONCLUSION: Nursing students cannot claim rights at this time, but expressed the desire to build a support system so that these parts can be improved in the future. Therefore, nursing education institutions and clinical fields should maintain diverse efforts through reciprocal relationships.
Education, Nursing ; Emigrants and Immigrants ; Focus Groups ; Hospitals, University ; Human Rights ; Humans ; Methods ; Nursing ; Students, Nursing

PURPOSE: The purpose of this mixed-method study was to identify the demand for mental health nursing education and work of nurses at a private psychiatric hospital.METHODS: The survey of demand for mental nursing education was conducted by including 231 nurses at a private psychiatric hospital from November to December, 2017. Qualitative research by two focus groups was conducted from October to November, 2018.RESULTS: The mean of mental health nursing education demands according to major category were the therapeutic environment (4.27±0.76), substancerelated and addictive disorders (4.18±0.68), therapeutic relationship and communication (4.17±0.64), respect for human (4.11±0.74), and neurocognitive disorders (4.07±0.74). The qualitative research participants’ demands for mental health nursing education were classified into five categories: ‘discrimination power’, ‘communication techniques’, ‘psychiatric drugs’, ‘coping method’, and ‘legal issues’.CONCLUSION: Nurses with less psychiatric careers have strong need to learn a therapeutic environment and alcoholism, and nurses with more experience in psychiatry have education of humanities. Nurses at private psychiatric hospitals have high demand for continous education of updated mental nursing to expand their extensive experience required for becoming more professional nurses in future.
Alcoholism ; Education ; Education, Nursing ; Focus Groups ; Hospitals, Psychiatric ; Humanities ; Humans ; Mental Health ; Methods ; Neurocognitive Disorders ; Nursing ; Psychiatric Nursing ; Qualitative Research